MODULE 4: BLOOD COLLECTION

• General Blood Collection Equipment and Supplies

  • Phlebotomy Chair
  • Phlebotomy Kit
  • Personal Protective Equipment (PPE)
  • Antiseptic vs Disinfectant
  • Gauze Pads/Cotton Balls
  • Needle and Sharps Disposal Container
  • Slides
  • Pen and Watch
• Phlebotomy Chair


  • Specialized chairs with adjustable armrests to achieve proper positioning of either arm
  • Found in the blood-drawing section
• Phlebotomy Kit


  • A tray that is transported by the phlebotomist to the patient’s bedside
  • Holds the specimen collection equipment
• Personal Protective Equipment (PPE)


  • Mask
  • Gloves (Nonsterile, Disposable latex, Nitrile, Neoprene, Polyethylene, Vinyl examination gloves)
  • Lab gown
• Antiseptic


  • Prevents or inhibits the growth of microorganisms
  • Cleans the site prior to blood collection
  • Safe to the human skin
  • Common types: 70% isopropyl alcohol, 70% ethyl alcohol, Benzalkonium chloride, Chlorhexidine gluconate, Hydrogen peroxide, Povidone-iodine, Tincture of iodine
• Disinfectant


  • Decontaminates surfaces and instruments
  • Used for blood spillage
  • Requires 1:10 dilution and 10 minutes contact time
• Gauze Pads


  • Made of loosely woven cotton
  • Kept in its wrapping until ready for use
  • Applied immediately upon withdrawal of the needle
• Needle and Sharps Disposal Container


  • Also known as "Sharps" container
  • Usually RED but majority in the lab are YELLOW
  • Has a biohazard symbol
  • Rigid, puncture-resistant, leakproof, disposable
  • With locking lids
• Slides


  • Used to make blood films for microscopic exams
• Venipuncture Equipment


  • Vein Locating Device (e.g., Venoscope II, Neonatal Transilluminator, Accuvein AV300)
  • Tourniquet (1 inch wide, 18-20 inches long, cleaned with 70% alcohol or 1:10 bleach solution)
  • Phlebotomy Needles (Hypodermic, Multi-sample, Winged infusion)
  • Gauge (related to the diameter of the lumen, inversely proportional to the diameter or bore size of the lumen)
• Specifications for cleaning

  • 1 inch wide and 18-20 inches long
  • Cleaned using 70% alcohol or 1:10 bleach solution
• Types of Phlebotomy Needles

  • Hypodermic
  • Multi-sample
  • Winged infusion
• Gauge


  • A number related to the diameter of the lumen
  • The gauge number is inversely proportional to the diameter or bore size of the lumen
  • The larger the gauge, the smaller the bore size
  • Gauge can range from 16-27
  • Gauge selection depends on the patient’s vein, type of procedure, and equipment used
  • For small and thin veins, use gauge 23-25
  • Most commonly used gauge is 20-21
  • For blood donation, use gauge 16-18
• Length


  • The depth of the vein is considered when selecting the length of the needle
  • Syringe needles and multi-sample needles are 1-1.5 inches
  • Butterfly needles are 1/2 to 3/4 inch
• Hypodermic Needle


  • Attached to a syringe via a Luer-lock tip
  • Usually uses needles of gauge 20-22
  • Cover immediately after use
• Multi-sample Needle

  • Beveled-point on each end
  • Threaded hub and adapter
  • Used to fill multiple collection tubes
• Butterfly Needle


  • For fragile veins
  • The first tube collected will become underfilled
  • May have a luer-lock adapter or an ETS adapter
• Causes of Premature Loss of Vacuum

  • Improper storage
  • Opening of the tube
  • Dropping of the tube
  • Advancing the tube too far onto the needle before venipuncture
  • Needle bevel becomes partially out of the skin during venipuncture
• Blood Additives

  • Anticoagulants
  • Clot activators
  • Antiglycolytic agents
• Anticoagulants


  • May be called blood thinners
  • Prevent blood clots either by precipitation of calcium or by preventing thrombin formation
• Clot activators


  Enhances coagulation in serum specimen tubes
• Antiglycolytic agents


  Prevent the breakdown of glucose by preventing glycolysis
• Anticoagulants

  • EDTA
  • Heparin
  • Citrate
  • Oxalate
• EDTA

  Chelates ionized calcium
• Heparin


  Inhibits thrombin formation
• Citrate


  Chelates ionized calcium
• Oxalate


  Precipitates calcium
• Clot activators


  • Glass or silica particles
  • Thrombin
• Antiglycolytic agents

  • Sodium fluoride
  • Lithium iodoacetate
  • Potassium oxalate
  • Lithium heparin
• Sodium fluoride


  Preserves glucose for 3 days
• Lithium iodoacetate


  Preserves glucose for 24 hours
• Potassium oxalate

  ACG: potassium oxalate
• Lithium heparin

  ACG: lithium heparin
• Sterile blood culture tubes

  • Microbiological tests
• Citrated tube


  • Coagulation tests or ESR
• Serum tube

  • Chemistry tests
• Heparinized tube


  • Chemistry tests
• EDTA tube


  • Hematological tests
• Oxalate/ Fluoride tube


  • Chemistry tests (glucose)
• Order of draw

  • Sterile blood culture tubes
  • Citrated tube
  • Serum tube
  • Heparinized tube
  • EDTA tube
  • Oxalate/ Fluoride tube